Abstract
Purpose Patients with ulcerative colitis (UC) frequently present with psychological disturbances as well as dysfunctions of autonomic nervous system (ANS). Salivary alpha-amylase (sAA) secretion is predominantly controlled by sympathetic nervous activity, while salivary fluid secretion is by parasympathetic nervous activity. Thus, it is speculated that alterations of salivary secretion may be addressed in UC populations. Methods Thirty-five UC patients as well as 32 age- and sex-matched healthy controls were enrolled. Saliva samples before and after citric acid stimulation were collected from each participant, and salivary flow rate (SFR) was calculated accordingly. Western blotting and quantitative PCR were applied to measure the sAA level and sAA gene (AMY1) copy number, respectively. The psychological disorders, anxiety and depression, were evaluated by the scoring system of Hospital Anxiety and Depression Scale (HADS) for each participant. Results We observed robustly increased prevalence of anxiety (p < 0.001) as well as depression (p < 0.001) in UC patients relative to controls. Interestingly, we detected elevated basal (p = 0.015) and stimulated (p = 0.021) sAA levels in the UC populations compared to controls. However, no differences were found for basal (p = 0.643) or stimulated (p = 0.402) SFR between the two study groups. Besides, AMY1 gene copy number was comparable between UC patients and controls. Conclusions Our results reveal an overactivity of the sympathetic nervous system and a normal activity of the parasympathetic nervous system in the UC population.
Highlights
Ulcerative colitis (UC) is a major form of inflammatory bowel disease and is characterized by chronic inflammation of the colon and rectum and by alternating periods of flares and remissions
We detected a significantly higher prevalence of psychological disturbances in the UC patients than controls, which was consistent with previous reports [4, 7]
Similar variations were obtained for the stimulated Salivary alpha-amylase (sAA) level, which varied from 89 μg/ml to 445 μg/ml and 96 μg/ml to 580 μg/ml in the controls and UC patients, respectively (Figure 2(b))
Summary
Ulcerative colitis (UC) is a major form of inflammatory bowel disease and is characterized by chronic inflammation of the colon and rectum and by alternating periods of flares and remissions. UC has emerged as a global disease because its incidence and prevalence are increasing with time and in different regions around the world [2] It is a lifelong illness with significant effects on the quality of life and is associated with increased risk of colorectal cancer due to its presence of local chronic inflammation [3, 4]. Unlike sAA secretion, salivary fluid secretion is mainly regulated by the parasympathetic nervous system. Together, measuring the salivary secretion, including the sAA contents and salivary flow, is able to reflect the sympathetic and parasympathetic nervous activities. Considering that (1) UC patients present with altered ANS activities as well as psychological disorders, (2) the ANS dysfunction serves as one of the pathophysiological link between the psychological disorders and UC, and (3) salivary secretion is mainly regulated by ANS activity, we expected alterations of salivary secretion in UC patients, which might further support the altered ANS activities in the population
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